| Richard E Johnson Dds | |
|
5646 N Palm Ave Suite 101 Fresno CA 93704-1848 | |
| (559) 431-6626 | |
| (559) 431-6499 |
| Full Name | Richard E Johnson Dds |
|---|---|
| Speciality | Dentist |
| Location | 5646 N Palm Ave, Fresno, California |
| Authorized Official Name and Position | Richard Evans Johnson (OWNER) |
| Authorized Official Contact | 5594316626 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Richard E Johnson Dds 2970 E Pryor Dr Fresno CA 93720-4498 Ph: (559) 940-0876 | Richard E Johnson Dds 5646 N Palm Ave Suite 101 Fresno CA 93704-1848 Ph: (559) 431-6626 |
| NPI Number | 1851698740 |
|---|---|
| Provider Enumeration Date | 02/11/2011 |
| Last Update Date | 02/20/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851698740 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 22814 (California) | Primary |
| 332BC3200X | Durable Medical Equipment & Medical Supplies - Customized Equipment | 22814 (California) | Secondary |
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